Menstruation While Breastfeeding

It is normal for all
women to have some postpartum bleeding following birth (including the moms who
have delivered through cesarean –C-section-). Although this is not considered a
menstrual period, if you stop lactating within days of birth, most mothers will
have their first “real” menstruation shortly after. The World Health Organization (WHO)
considers any bleeding 56 or more days after birth to be menstruation.

If you are
breastfeeding, starting back to your menstruation and the continuity of it
becomes very complex. Many breastfeeding mothers do not get their regular
menstruation for the duration of exclusive breastfeeding. The absence of a period during
breastfeeding is called “lactational amenorrhea.”Once their babies begin
taking supplemental foods or sleeping longer periods at night, mothers may see
the first period. Some mothers may even need to wean completely before they see
their first period. It is usual to see irregularities with your menstruation
during lactation.This can be the period
between the two menstruations, the duration of the periods; your flow could be
heavier or lighter. It is also common to skip a period or see the first period
return and then find that months pass before the next one.

Here are some of the
factors that will effect your periods;

How frequently the baby is nursing
: The longer and more often the baby nurses, the less chance you will get
your period back.

Baby’s longest sleep period: When
the baby starts to sleep through the night, (usually 5+ hour stretches)
you may start to look for the telltale signs of your first period.

How much nursing taken at the
breast: Supplementing with formula or solid foods will decrease the nipple
stimulation and changes the hormone responses. Some studies suggest even
mothers who pump more often than nurse their babies do see some decrease
in their milk production and returning of their menstruations.

Pacifiers/ Dummies /Binkies: These
all suppresses the baby’s natural need for suck, and communicate his/her
hunger to the mother. This will increase the time between feedings and
your menstruation is likely to return sooner.

Hormone-receptor relation:
Mother’s own individual body chemistry and the way it reacts to the
hormonal responses will determine your menstrual periods.

Fertility;

Presence of
menstruation is not always a good way of determining if you are ovulating –i.e.
if you are fertile or not - .Nevertheless,
it is very good idea to take precautions against unexpected pregnancy. Using breastfeeding as an
exclusive form of birth control is known as the lactational amenorrhea method
(LAM). This method, although efficient when used correctly, you may need to
master it before use it as the only form of birth control. Please remembereven though quite
rare, it is possible to become pregnant before the first period
returns.

Tender Nipples;

Nipple tenderness is
a common problem for some women during ovulation, during the days before a
period, or at both times. Some mothers report a feeling of emptiness while
nursing at these times, too. As with the drop in supply, this is hormonally
influenced and therefore temporary.Please note that this is different from postpartum depression and if it
is lasting more than 10 days please contact to your healthcare provider for an
evaluation.

Sour Milk?

Some mothers worry
that once they start having their period their milk turn sour and it is no
longer good or sufficient for their baby. Please be assured this is not the
case.Some babies may detect a slight
change in the taste of the milk (usually saltier not sour) just before a
period, due to hormonal changes. These babies may nurse less often or less
enthusiastically during this time.

Milk Supply;

It is not unusual to
notice a temporary drop in milk supply in the days just prior to a period and
for a few days into one. Mothers who are over 30 seem to be more prone to this.
This is due to hormonal fluctuations. Once the period begins and hormone levels
begin to return to normal, the milk supply will boost back up again. Most
babies can compensate well for this temporary drop in supply with more frequent
nursing. If you are pumping regularly and getting less milk, you may consider
adding one or two extra pumping sessions a day to catch up. If you have supply issues to
begin with, speak to your healthcare provider or a lactation consultant if you feel you need help during
this time.

Some mothers find
nursing while their milk supply is low and nipples are tender a big
challenge.Many mothers find adding a
calcium/magnesium supplement to the diet upon ovulation and continue it through
the second or third day of a period an effective way to deal with these
symptoms. *The supplement should be 1500 calcium/750 magnesium
but can be as low as 500 calcium/250 magnesium (the higher the dosage the more
effective and quicker the results). It should be a combination pill. This much
calcium should never be taken alone. If your cycles are not regular and you do
not know when you ovulate, you can take the supplement the entire month until you
begin to see a pattern to your flow. This type of supplement seems to work as
it prevents the drop in blood calcium levels, which occurs mid-cycle and
continues through the second to third day of a period. It is this drop, which
is associated with the nipple tenderness and drop in milk supply as well as the
uterine cramping so often experienced with menstruation. You only need to take
one pill a day.

The herb, Evening
Primrose, is also reported to alleviate nipple soreness brought on during
ovulation or before a period. The dosage is one capsule per day.*

As any medication or
supplements please make sure, you consult your healthcare provider if the
above-mentioned treatment is suitable for you.

*By Becky
Flora, BSed, IBCLC

The above information is true at the time of update (10/29/2009). The information on www.BabyAndMeLC.comis
for general information only. If you have serious concerns about your
baby or breastfeeding, speak to your healthcare provider as soon as
possible.